Here’s what it’s like to live with a period disorder — and why we need to talk about it.

Though I’ve had it since I was 10 years old, it took me almost a decade to realize that my period was not normal.

I always noticed that my cramps were very intense prior to my period. I also cycled through extreme mood swings, felt lightheaded, lacked energy, and experienced symptoms of depression. Not the passing, mope-around-in-your-bed-eating-ice-cream emotional slump — this was depression that affected my everyday life. It made me feel like a completely different person. Leading up to my period, my normally confident, capable self gave way to an intensely anxious, harshly self-critical version of me that I hardly recognized.

But as someone who’s suffered from depression, anxiety, and IBS throughout my whole life, I thought it was normal. My high school nurse said it was just PMS and stress, and my mother agreed. During my first year of college, I noticed that my symptoms grew even worse. They began affecting my schoolwork and attentiveness. I often felt like I wasn’t really able to respond to my surroundings due to my lack of energy.

I couldn’t understand what was going on in my body or causing these changes. My peers seemed to not have any of these same issues with their periods. That’s when I realized there was something wrong, and I finally visited a nurse practitioner in my college and asked for help.

I received a diagnosis: premenstrual dysphoric disorder (PMDD), a more severe form of PMS.

For the first time, everything made sense. PMDD is rare, occurring in only 2%-10% of people who menstruate, and mostly occurs in those who have depression disorders. The symptoms include fatigue, decreased interest in activities that are typically enjoyable, and difficulty concentrating, plus more intense versions of the mood swings and cramps that come along with regular PMS.

While I felt relieved to know exactly why I was feeling the way I did, it didn’t make my life any easier. The nurse practitioner prescribed low-Ogestrel birth control pills, which were supposed to regulate the symptoms caused by PMDD. Those helped for a year or so, until they began to make me feel sick. After starting feeling nauseous each time I took the pill, I decided I was a better off without it.

Then, when I moved to study abroad, things got even worse.

I moved to England, where I wasn’t able to find a gynecologist. I had to deal with my symptoms completely on my own — which is, as I know now, not a good strategy for coping with PMDD.

Walking around in temperate weather made me feel like I was about to faint. I found it difficult to do normal errands, like buying groceries or following directions. My depression also worsened, making everything even more difficult to deal with.

Some days, I’d be perfectly fine and happy. But a week or so before my period, I’d become this lethargic, self-loathing person. Sometimes I couldn’t even summon enough energy to brush my teeth or take a shower — things I do daily whenever I’m mentally healthy.

Even though I’m back in the U.S. now, my PMDD still isn’t something that can be easily solved by going to the doctor and getting medicine. I’ve already tried birth control, so my next option would be antidepressants. But since I don’t have American health insurance, antidepressants would cost a lot — more than I can afford right now. I’ve been postponing getting medication, but it’s something I intend to solve soon.

But the hardest part of PMDD is that I always know it’s coming, but for a long time, I didn’t know how to prepare for it.

Menstruation is still so stigmatized in society that it makes it difficult or impossible to communicate what I struggle with and get the support I need.

In school, I’d be an efficient worker and student, until my PMDD hit each month. But telling professors or employers that my performance level would go down due to a period-related disorder was seldom taken seriously. And that’s assuming they would talk to me at all — many people don’t want to discuss menstruation, even clinically, because it’s still considered intimate and taboo to talk about.

People’s periods are rarely taken seriously as a cause of true mental or physical distress. We’re just expected to deal with it or ignore it, despite it being a big part of our lives. I’m sick of being told “Déjate de changuerías” (Puerto Rican slang that loosely translates to “Stop whining”) when I’m dealing with PMDD and my period. Even those who don’t have PMDD still suffer through symptoms that can be extremely unpleasant and painful. It’s time to leave behind the taboo of discussing periods and bring to light these issues that show that menstruation is more than a monthly chocolate craving — it’s a real struggle facing millions of people who need others to listen, understand, and support us.